Abstract
Diarrhoeal diseases are one of the most important causes of illness and death all over the world. In Nigeria, the aetiology of diarrhoeagenic bacteria and the virulence of various Escherichia coli pathotypes have not been well-studied because most currently-published data were from the southwestern axis of the country. In total, 520 stool samples were collected from infants, young children, and other age-groups with acute diarrhoeal diseases in Enugu and Onitsha, southeastern Nigeria. Stool samples were collected from 250 apparently-healthy individuals, with similar age distribution and locality, who were considered control subjects. The stool samples were screened for diarrhea-causing bacterial agents. E. coli strains were isolated from both the groups and were examined by polymerase chain reaction (PCR) for 16 virulence genes. Of the 520 stool samples in the diarrhoea group, 119 (44.74%) were E. coli. Fifty (49.02%) were enteropathogenic E. coli (EPEC), 22 (21.57%) were enterotoxigenic E. coli (ETEC) while 7.84% was enteroaggregative E. coli (EAEC). Sex had no effect on the distribution of diarrhoeagenic bacteria, except for EIEC. The E. coli strains isolated from the diarrhoea and healthy asymptomatic age-matched control groups examined by PCR for 16 virulence genes indicate that the detection of EAEC, ETEC, EPEC, and EIEC was significantly associated with diarrhoea (p=0.0002). The study confirmed that several bacterial pathogens, such as E. coli, play an important role in the aetiology of acute diarrhoea in southeastern Nigeria. A routine surveillance, especially for diarrhoeagenic E. coli, would be useful in identifying outbreaks and help identify the potential reservoirs and transmission routes.
Highlights
Diarrhoeal diseases and other related gastrointestinal disorders are one of the most important causes of illness and death all over the world, among infants and young children [1,2,3]
The incidence of different E. coli strains encountered in the study according to sex groups showed that enteropathogenic E. coli (EPEC) accounted for 30 (29.41%) of the total E. coli isolates, with 14 (46.67%) males and 16 (53.33%) females
In Nigeria and many developing countries, diarrhoea caused by bacterial pathogens, especially E. coli, remains one of the major causes of morbidity and mortality among infants and young children [9,11,18]
Summary
Diarrhoeal diseases and other related gastrointestinal disorders are one of the most important causes of illness and death all over the world, among infants and young children [1,2,3]. The major causes of diarrhoeal illness include, among others, limited access to or poor quality of water, poor food hygiene, and sanitation. The bacterial pathogens usually responsible for diarrhoeal illness include Escherichia coli, Shigella, Salmonella, Campylobacter, Yersinia, Aeromonas, etc. Five major classes of diarrhoeagenic Escherichia coli (DEC) are associated with diarrhoeal diseases. These are: enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC), and enteroaggregative E. coli (EAEC). Each of the several classes of DEC is defined based on the distinct virulence characteristics. Tests for these characteristics have been developed to Diarrhoea among subjects in Southeast Nigeria
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